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Biomedical subjects

J L Schlienger

Publications and source records attributed to J L Schlienger.

At least 145 records · Page 8Linked to original sources
PubMed1989

[Diminution of thyroid stimulating hormone level but normal levels of thyroid hormones. Demonstration of occult hyperthyroidism].

The finding of a low basal concentration of thyroid-stimulating hormone (TSH) in the absence of high thyroid hormone levels is difficult to understand. In order to elucidate the meaning of such a dissociation, 22 patients without history of thyroid disease and showing clinical signs compatible with thyrotoxicosis were explored by the thyrotrophin-releasing hormone (TRH) test, by thyroid radioisotope scanning and, in case of high nodular uptake, by the triiodothyronine suppression test. A specific surgical, isotopic or medical treatment was instituted in the 17 patients who had a high nodular uptake unsupressible by triiodothyronine. During a clinicobiological re-evaluation carried out 6 months later, a significant clinical improvement was observed in 8 patients, and 12 patients whose free thyroxine level had decreased showed normal TSH levels. These results underline the value of thyroid radioisotope scanning in patients with isolated diminution of TSH. They confirm the reality of occult hyperthyroidism with normal thyroid hormone levels by the benefits observed after specific treatment.

Aged↗
PubMed1989

[Endocrine consequences of infection by human immunodeficiency virus (HIV)].

The acquired immunodeficiency syndrome (SIDA) is a severe multivisceral affection that is sometimes composed of a clinical expression compatible with an endocrine insufficiency. The post-mortem verifications confirmed the high frequency of the suprarenal, pituitary and testicular lesions. The hormonal functional exploration confirmed the possibility of a decrease in the cortical suprarenal function that contrasts with a moderate hypercortisolemia and an hypogonadism without elevation of the gonadotrophins. The clinical expression of the deficits is unusual. Nevertheless a few cases of obvious suprarenal or antepituitary insufficiency bond to a secondary inflammatory necrosis, an infection by CMV, or a toxoplasmosis have been reported. More often, these hormonal alterations are moderate. There mechanisms are still imprecise. The non-specific response to the stress led by the disease doesn't give an explanation to the observed abnormalities. The described existence of antihormone antibodies in AIDS or the secretory potentialities of the activated lymphocytes might contribute to the physiopathology of the endocrine modifications outside of any infections or endocrine metastatical localisation.

Acquired Immunodeficiency Syndrome↗
PubMed1988

[Disorders of plasma trace elements in diabetes. Relation to blood glucose equilibrium].

The influence of glycaemic control and diabetes characteristics on plasma concentrations of magnesium, zinc, copper, selenium, rubidium and bromine has been evaluated in 44 diabetics (30 insulin-dependent, 14 non insulin-dependent), and the results obtained were compared to those of 309 control subjects of the same mean age. Diabetics had reduced plasma magnesium concentrations (P less than 0.01) but normal erythrocyte magnesium levels. Plasma zinc and selenium concentrations were reduced, whereas those of copper were increased and those of bromine and rubidium were normal. Correlation between glycaemic control, evaluated by measurement of glycosylated haemoglobin levels, and each of the parameters studied was only demonstrated with magnesium in insulin-dependent diabetics (r = -0.561; P less than 0.02). No correlation was found with the other clinical or anthropometric characteristics of the diabetic patients studied. Diabetes seems to be associated with numerous abnormalities of plasma trace elements and magnesium, but the mechanism of these abnormalities has not yet been elucidated. A decrease in zinc and selenium concentrations and an increase in copper concentrations might be additional factors of atherogenicity.

Adult↗
PubMed1988

[Systematic ultrasensitive determination of thyroid-stimulating hormone in 50 cases of atrial fibrillation].

The incidence of hyperthyroidism in patients with continuous arrhythmia due to atrial fibrillation was evaluated prospectively by means of the "ultrasensitive" assay of thyroid-stimulating hormone (TSH). When the result was abnormal, free thyroxine fractions (FT4) and free triiodothyronine fractions (FT3) were measured, and in some cases a thyrotropin-releasing hormone (TRH) test and a thyroid gland scintigraphy were performed. Among 50 unselected patients with continuous arrhythmia due to atrial fibrillation, 12 had a low TSH baseline level. In 7 of them, high FT4 and/or FT3 levels provided evidence of hyperthyroidism. In the remaining 5 patients FT4 and FT3 levels were normal, but TSH response to TRH was suppressed and scintigraphy showed a high nodular or lobular uptake. In a control series of 50 age- and sex- matched subjects without thyroid disorders or dysrhythmia, TSH level was low in only one case with insufficient response to TRH, but the scintigraphic image did not suggest nodular hyperthyroidism. It is concluded that systematic TSH assays can detect those atrial fibrillations which are consecutive to, or aggravated by hyperthyroidism, even asymptomatic. We regard this assay as indispensable to evaluate continuous arrhythmia due to atrial fibrillation, even when an apparently causative underlying heart disease is present.

Adult↗
PubMed1988

Intestinal ammonium production in the rat: the role of the colon, small intestine, and circulating glutamine.

The intestinal ammonium production and the intestinal uptake of circulating glutamine were investigated in anesthetized intact rats and rats with resected small intestine or colon by simultaneous measurements performed on portal and arterial blood. It was shown that ammonium release into the portal blood by the small intestine is of equal magnitude to that released by the colon, and that circulating glutamine participates in ammonium production by the small intestine. Increased levels of circulating glutamine induced by its i.v. infusion to intact rats were not accompanied by an increase in intestinal ammonium production.

Ammonia↗
PubMed1988

REM sleep in humans begins during decreased secretory activity of the anterior pituitary.

The purpose of this study was to define the temporal relationship between anterior pituitary hormone profiles and rapid-eye-movement (REM) sleep occurrence. Plasma levels of prolactin (PRL), adrenocorticotropic hormone (ACTH), luteotropin (LH), thyroid-stimulating hormone (TSH) and growth hormone (GH) were measured in 10 min blood samples. Analysis of the nocturnal profiles for these hormones and the concomitant patterns of sleep stage distribution indicate that the onset of REM sleep very seldom occurred during the increasing phase of secretory episodes. In 93-98% of cases, depending on the hormone studied, it occurred either during the declining phase, at peak level, or at nadir, each of these phases reflecting a decrease in glandular activity. This relationship differed from the very close association previously found between the sleep stage alternation and plasma renin activity. These findings seem to fit in with the concept of reduced sympathetic activity and disruption of the vegetative functions during REM sleep.

Adrenocorticotropic Hormone↗
PubMed1987

TRH-induced TSH and prolactin responses in the elderly.

Since there are divergencies in the thyrotropin (TSH) response to thyrotropin-releasing hormone (TRH) in old age, and since a hypothalamopituitary dysfunction has been suggested in the elderly, we have studied the thyroid function and the TRH responsiveness of TSH and prolactin (PRL) in 56 euthyroid patients over 70 years old, grouped according to age (70-79, 80-89, 90 or more years) and sex. Results were compared to those of 15 postmenopausal women and 11 men. In the elderly patients there was a decrease in plasma tri-iodothyronine (T3) and an increase in reverse T3 (rT3) levels while thyroxine (T4), basal TSH and PRL levels remained normal. The mean TSH and PRL responses to TRH (250 micrograms i.v.) were reduced but there was no age effect within the elderly. Only a sex effect was detected, TSH and PRL responses being appreciably lowered in men. In eight patients without severe disease or malnutrition, the response of TSH was not significant. We conclude that despite an apparent euthyroid status, TSH and PRL responses are blunted in elderly patients, and more in men than in women. These data, consistent with a hypothetical hypothalamopituitary dysfunction, indicate the difficulties of thyroid status assessment in the elderly.

Aged↗
PubMed1987

[Study of salivary cortisol using radioimmunological assay. Diagnostic value].

Salivary cortisol levels reflect the biologically active "free" fraction of blood cortisol. The authors describe the results obtained with the aim of a radio-immunoassay commercial serum cortisol kit, without prealable extraction in different physiological and pathological situations. Salivary cortisol determination appears performant both in nycthemeral studies and in stimulation or freination tests.

Adult↗